Youth Baptismal Form

Youth Baptismal Information Form

Please answer the following questions. This information is necessary so that the Seventh-day Adventist (SDA) Church maintains accurate records of church members and to ensure your child’s baptism performed by Pastor Ezra Okioma at Cornerstone SDA Church in Wichita, Kansas is formally documented in SDA church records. Questions? Send an email to: info@wichitacornerstone.org

Company

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Name of Child Baptismal Candidate*

First Last

Date of Baptism*

Child's Age*

Please enter a number from 5 to 18.

Date of Birth*

Languages (Select multiple by holding down 'control' key)*

Ethnicity

Address*

Street Address City State ZIP / Postal Code Country

Parental "or" Guardian Contact Information

Father's Name

First Name Last Name

Father's Marital Status*

Father's Spouse

First Name Last Name

Father's Religion

Father's Church Name

Father's Cell Phone*

Father's Email*

Enter Email Confirm Email

Mother's Name

First Name Last Name

Mother's Marital Status*

Mother's Spouse

First Name Last Name

Mother's Religion

Mother's Church Name

Mother's Cell Phone*

Mother's Email*

Enter Email Confirm Email

Guardian's Name

First Name Last Name

Guardian's Religion*

Guardian's Church Name

Guardian's Phone*

Guardian's Email*